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FY2027 ICD-10-CM reference

F03.A11: Unspecified dementia, mild, with agitation

By the HCC Buddy Coding Team

The official ICD-10-CM descriptor is Unspecified dementia, mild, with agitation. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Billable code. Verified against the official FY2027 order file.

CMS-HCC V28

  • HCC 127: Dementia, Mild or Unspecified · RAF 0.341, Community Non-Dual Aged (CNA)

Payment year 2027, 2026 dates of service. HCC from the CMS 2027 Initial ICD-10-CM Mappings; RAF from the CMS-HCC V28 relative factors. For 2027 dates of service, CMS has not yet published the payment year 2028 mappings.

CMS-HCC V24

Not used for payment year 2027 Medicare Advantage payment

ESRD

Source verification pending

PACE

Source verification pending

RxHCC

Source verification pending

HHS-HCC

Source verification pending

FY2027 Tabular instructions

Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.

Includes

disorders of psychological development

Source: F01-F99 (chapter, inherited).

Excludes2

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

Source: F01-F99 (chapter, inherited).

Instructional note

This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved.

Source: F01-F09 (section, inherited).

Instructional note

Major neurocognitive disorder NOS

Source: F03 (category, inherited).

Instructional note

Presenile dementia NOS

Source: F03 (category, inherited).

Instructional note

Presenile psychosis NOS

Source: F03 (category, inherited).

Instructional note

Primary degenerative dementia NOS

Source: F03 (category, inherited).

Instructional note

Senile dementia NOS

Source: F03 (category, inherited).

Instructional note

Senile dementia depressed or paranoid type

Source: F03 (category, inherited).

Instructional note

Senile psychosis NOS

Source: F03 (category, inherited).

Excludes2

dementia with delirium or acute confusional state (F05)

Source: F03 (category, inherited).

Excludes2

mild memory disturbance due to known physiological condition (F06.8)

Source: F03 (category, inherited).

Excludes1

mild neurocognitive disorder due to known physiological condition with or without behavioral disturbance (F06.7-)

Source: F03.A (self, inherited).

Instructional note

Unspecified dementia, mild, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking

Source: F03.A11 (self, direct).

Instructional note

Unspecified dementia, mild, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence

Source: F03.A11 (self, direct).

Source: CMS FY2027 Tabular List and Alphabetic Index.

Open Tabular instructions and code details

Compare the FY2027 additions, removals and billable-status changes

What does F03.A11 mean in FY2027?

The official ICD-10-CM descriptor is Unspecified dementia, mild, with agitation. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Is F03.A11 billable in FY2027?

The FY2027 order file marks F03.A11 as billable. Check the complete Tabular instructions and documentation before assigning it.

Does F03.A11 map to an HCC?

In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), F03.A11 maps to CMS-HCC V28 HCC 127 (Dementia, Mild or Unspecified). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. ESRD, RxHCC, PACE and HHS-HCC mappings are still pending verification for FY2027.

Source: CMS FY2027 ICD-10-CM order file. Read the FY2027 Official Guidelines.

Review the FY2026 April edition